Individual
ETHELAINE CENTENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1615 S. RANCHO SANTA FE ROAD, SAN MARCOS, CA 92078
(619) 339-5606
Mailing address
PO BOX 507073, SAN DIEGO, CA 92150
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3520
CA
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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